ECDC launches toolkit for foodborne, waterborne outbreaksThe European Centre for Disease Prevention and Control (ECDC) yesterday launched a toolkit to help member states identify, investigate, and control food- and waterborne disease (FWD) outbreaks. The toolkit includes checklists, templates, guidelines, explanatory texts, and applications using EpiData, software developed for field epidemiologic investigations. On the toolkit home page, the ECDC says, "The primary purpose is to provide material that can be helpful when coordinating European FWD outbreak investigations." The home page says the toolkit could also be useful for investigating country-level outbreaks. The toolkit, produced by experts at Statens Serum Institut in Copenhagen and the Norwegian Institute of Public Health in Oslo, is meant to evolve as new features are added. The eight tools currently featured are: (1) when to consider an international investigation, (2) a checklist for teleconferences, (3) case definitions, (4) recommendations for finding cases, (5) questionnaire investigations using EpiData, (6) data analysis and analytical studies, (7) considerations for environmental and microbiological studies, and (8) alert systems.Feb 21 ECDC news releaseECDC toolkit home page

Study: Pig MRSA may have originated in humans, then become resistantMethicillin-resistant Staphylococcus aureus (MRSA) clonal complex 398 (CC398)—a type that is common in pigs but has also been identified in humans—likely originated as methicillin-susceptible S aureus (MSSA) in people, jumped the species barrier to swine and became drug-resistant, and then re-infected humans, according to a study yesterday in mBio. An international research team performed a phylogenetic analysis of both MSSA and MRSA CC398 isolates from pigs and people in Europe, North America, and China. They found that MSSA from humans formed most ancestral clades, whereas the most developed lineages primarily consisted of pig MRSA. The researchers write, "The jump of CC398 from humans to livestock was accompanied by the loss of phage-carried human virulence genes, which likely attenuated its zoonotic potential, but it was also accompanied by the acquisition of tetracycline and methicillin resistance." They conclude, "Our findings exemplify a bidirectional zoonotic exchange and underscore the potential public health risks of widespread antibiotic use in food animal production."Feb 21 mBioabstract

Measles cases in Europe topped 30,000 again in 2011Measles cases in 29 European countries totaled 30,567 in 2011, up slightly from the 30,264 in 2010 and four times more than the 7,175 cases in 2009, the ECDC reported yesterday. France accounted for about half of the cases (15,206) and had the highest rate per 100,000 population at 23.4. More than 90% of the cases occurred in five countries: France, Italy, Romania, Spain, and Germany. Twenty-four of the 29 reporting countries had more cases in 2011 than the year before, and the only measles-free countries were Iceland and Cyprus. On the positive side, Bulgaria had only 157 cases last year, after battling an epidemic of 22,000 cases in 2010, the report said. It also noted that Ukraine is fighting an ongoing measles outbreak, with more than 3,000 cases so far this year. The country will host the 2012 European Football Championship in June, and unvaccinated visitors will run a risk of infection, the ECDC said.Feb 21 ECDC press releaseECDC measles surveillance reportMeanwhile, Indiana health officials yesterday confirmed the state's 15th measles case in an outbreak that began early this month in central Indiana. The latest case-patient knew he or she had been exposed and stayed home to protect others, the Indiana State Department of Health (ISDH) said in a news release. "Through our investigation, we were made aware that this individual was exposed and may be at high risk for developing the disease," State Health Commissioner Gregory Larkin, MD, said in the release. "This is good news, because since we knew about the exposure and risk, this person was able to stay home and avoid exposing anyone else while infectious."Feb 21 ISDH press release